Not upheld: claim decline — failure to comply with notification requirements complaint against AmTrust Specialty Limited

Decision detail

Summary

Mrs B and Mr B purchased a new-build property in 2020 with an AmTrust warranty and made a claim in January 2024 for cornerstone cracking caused by a building defect. AmTrust declined the claim as falling within the structural insurance period (years 3-10) where cover requires major damage. Mr B then argued the claim should be covered under the defects period (years 1-2) where all defects are covered, claiming he had raised the issue with the developer during that period. However, the ombudsman found that while Mr B likely did raise the issue with the developer during years 1-2, he failed to notify AmTrust's scheme administrator in writing within six months of the end of the defects period, as required by the policy terms. The ombudsman rejected arguments that a telephone call should have been recorded or that the terms were unfair, and upheld AmTrust's decision to decline the claim.

The Ombudsman's reasoning

The ombudsman found that while Mr B likely did raise the issue with the developer during the defects period (years 1-2), he failed to meet the second contractual requirement: notifying AmTrust's scheme administrator in writing within six months of the end of the defects period. The ombudsman rejected Mr B's argument that a telephone call to the scheme administrator during the defects period should have been recorded as notification, finding no contractual or moral obligation for the administrator to do so. The ombudsman also rejected the argument that the policy terms were inherently unfair, noting that insurers are entitled to set clear contractual terms and that AmTrust deliberately limited defects period cover to claims notified within the specified timeframe.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website